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371.
Emily Jackson 《The Modern law review》2010,73(3):399-427
This article examines the implications for patient care, and for the future of rationing within the NHS, of the recent decision to permit NHS patients to supplement their care by paying for medicines — mainly expensive new cancer drugs — which are not available within the NHS. The starting point is the recommendations of the Richards' Report and their implementation through new guidance issued by the Department of Health and the National Institute for Health and Clinical Excellence. Practical challenges arise from the insistence upon the ‘separate’ delivery of self‐funded medicines, and more flexible cost‐effectiveness thresholds for end of life medicines may have repercussions for other patients. While undoubtedly part of the trend towards explicit rationing, top‐up fees might also represent a significant step towards regarding the NHS as a core, basic service. Finally, the issue of top‐up fees is located within the broader context of current cancer research priorities and persisting health inequalities. 相似文献
372.
This article considers how well evidentiary processes withinthe international criminal tribunals match up to the challengeto provide fair and reliable verdicts. Rather than using theadversarial–inquisitorial dichotomy as the basis for exploringthis question, the article takes as its reference point thewell recognized norms of equality of arms and the right to adversarialprocedure. It is argued that although the tribunals have metthe minimum standards of fairness required by these norms, thecombination of adversarial party presentation and free admissionof evidence, within an evidentiary context in which it is difficultfor the defence to make their own inquiries, has restricteddefence access to information and its ability to challenge evidence.The article goes on to argue that some of these shortcomingshave been addressed within the International Criminal Courtby the establishment of a Pre-Trial Chamber but that the Chamberneeds to be developed further to promote a truly participativeapproach to fact-finding between the parties. 相似文献
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377.
Stephen Jackson 《冲突、安全与发展》2006,6(3):425-447
378.
Collin OL Niegel C Derhodes KE McCord BR Jackson GP 《Journal of forensic sciences》2006,51(4):815-818
The detection of a mixture of nine explosive compounds, including nitrate esters, nitroaromatics, and a nitramine in less than 140 sec is described. The new method employs a commercially available pulsed-discharge electron capture detector (PDECD) coupled with a microbore capillary gas chromatography (GC) column in a standard GC oven to achieve on-column detection limits between 5 and 72 fg for the nine explosives studied. The PDECD has the benefit that it uses a pulsed plasma to generate the standing electron current instead of a radioactive source. The fast separation time limits on-column degradation of the thermally labile compounds and decreases the peak widths, which results in larger peak intensities and a concomitant improvement in detection limits. The combination of short analysis time and low detection limits make this method a potential candidate for screening large numbers of samples that have been prepared using techniques such as liquid-liquid extraction or solid-phase microextraction. 相似文献
379.
In December 2002, approximately 250 lbs. of ground beef was adulterated with nicotine sulfate by a supermarket employee and subsequently sold to the public. Soon afterward, reports of illness associated with ground beef purchased at a single store were identified. Authorities suspected the ground beef was tainted with Black Leaf 40, a banned pesticide containing approximately 40% nicotine as nicotine sulfate. Ground beef submitted to our laboratory was analyzed in concert by high performance liquid chromatography-ultraviolet detection (HPLC-UV), gas chromatography-mass spectrometry (GC-MS), and high performance anion exchange chromatography with suppressed conductivity detection. GC-MS was used to identify the samples that contained nicotine. The nicotine was confirmed and quantitated by HPLC-UV. The sulfate was identified and quantitated by high performance anion exchange chromatography with suppressed conductivity detection. Our analysis revealed that the raw tainted beef contained about 350 mg/kg nicotine free base, a potentially lethal dose of nicotine per serving for an adult. Additionally, we found elevated sulfate levels in the samples that tested positive for nicotine, providing evidence that nicotine sulfate was the probable adulterant. 相似文献
380.
Loewe C Diaz F Jackson A 《The American journal of forensic medicine and pathology》2005,26(3):297-301
We present a case of peritonitis and death due to the misplacement of a laparoscopic adjustable band inserted through, instead of around, the stomach. This represents the first case in the published literature where a LAP-BAND perforated the stomach, followed by peritonitis and death. The morbidly obese female patient with a history of hypertension and arthritis was 47 years old, 5 feet 6 inches tall, weighed 361 pounds, and had a body mass index of 58.3. She underwent a 2-hour, elective, LAP-band insertion operation to achieve weight loss; 27 hours after band insertion, following the conduction of all FDA-mandated Lap-Band postoperative protocol (including a radiologic Gastrogrografin swallow), the patient was discharged with "no evidence of esophageal stasis or obstruction." She remained out of hospital care and in her residence until she called for and was taken by an ambulance to an alternate, local hospital (57 hours after band insertion), when gastric perforation was confirmed via x-ray and CT scans. No open surgery was attempted to repair the damage, and cardiac arrest ensued 7 hours after admission to the second hospital. The patient was pronounced dead 64 hours after LAP-band insertion. This unique case is significant, given that there were no deaths of this kind reported in The LAP-BAND(R) Adjustable Gastric Banding System Summary of Safety and Effectiveness Data by the United States Center for Devices and Radiologic Health, of the Food and Drug Administration, or in searches of the published literature. 相似文献